Emergency visit, high (level 4) at CHI Health Missouri Valley. CPT 99284.
What CHI Health Missouri Valley publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$168cash price (self-pay)
$759list price
$85.50–$1,152range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana | Medicare|All Plans | $249 |
| Medica | Medicare|All Plans | $249 |
| PACE | Medicare|All Plans | $249 |
| United | Medicare|All Plans | $249 |
| Centene | Medicare|All Plans | $254 |
| Amerigroup | Medicare|All Plans | $261 |
| Great Plains | Medicare|All Plans | $261 |
| United | Medicaid|Community Plan | $326 |
| Amerigroup | Medicaid|All Plans | $333 |
| Total Care | Medicaid|All Plans | $333 |
| IAMolina | Medicaid|All Plans | $339 |
| AMPS | Commercial|All Plans | $552 |
| BCBS - NE | Commercial|BluePrint | $685 |
| Medica | Commercial|All Other Plans | $691 |
| Medica | Commercial|CHI Health | $691 |
| BCBS - NE | Commercial|All Other Plans | $721 |
| Greater Omaha Packing | Commercial|Broad Network | $729 |
| Greater Omaha Packing | Commercial|Narrow Network | $729 |
| Medica | Commercial|ACO | $729 |
| Medica | Commercial|Open Access | $729 |
| Midlands Choice | Commercial|Premier | $729 |
| Midlands Choice | Commercial|Standard | $729 |
| Millard Public Schools | Commercial|Broad Network | $729 |
| Millard Public Schools | Commercial|Narrow Network | $729 |
| One World | Commercial|Broad Network | $729 |
| One World | Commercial|Narrow Network | $729 |
| QuikTrip | Commercial|All Plans | $729 |
| Timpte | Commercial|Broad Network | $729 |
| United | Commercial|All Plans | $729 |
| MultiPlan | Commercial|All Plans | $744 |
Inpatient
$168cash price (self-pay)
$759list price
$195–$1,152range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark | Commercial|HMO | $433 |
| Wellmark | Commercial|PPO | $433 |
| BCBS - NE | Commercial|BluePrint | $685 |
| Medica | Commercial|All Other Plans | $691 |
| Medica | Commercial|CHI Health | $691 |
| BCBS - NE | Commercial|All Other Plans | $721 |
| Greater Omaha Packing | Commercial|Broad Network | $729 |
| Greater Omaha Packing | Commercial|Narrow Network | $729 |
| Medica | Commercial|ACO | $729 |
| Medica | Commercial|Open Access | $729 |
| Midlands Choice | Commercial|Premier | $729 |
| Midlands Choice | Commercial|Standard | $729 |
| Millard Public Schools | Commercial|Broad Network | $729 |
| Millard Public Schools | Commercial|Narrow Network | $729 |
| One World | Commercial|Broad Network | $729 |
| One World | Commercial|Narrow Network | $729 |
| QuikTrip | Commercial|All Plans | $729 |
| Timpte | Commercial|Broad Network | $729 |
| United | Commercial|All Plans | $729 |
| MultiPlan | Commercial|All Plans | $744 |
| PHCS | Commercial|All Plans | $744 |
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